Diseases that should be differentiated from vulvar leukoplakia

Leukoplakia vulvae presents as white, thickened, infiltrative plaques with clear borders, some with chapped skin, small erosions, and ulcers. The lesions are more likely to occur on the vaginal mucosa, urethral mucosa, clitoris, inner and outer sides of the labia minora, and the inner side of the labia majora, and are single or several irregular patches. Clinically, leukoplakia vulvae should be differentiated from diseases such as white keratosis, lichen planus, and sclerosing atrophic lichen.

1. White keratosis: White keratosis often presents as hypopigmented spots with no infiltration or mild infiltration, unclear borders, and mild itching. Long-term unhealed white keratosis can further develop into vulvar leukoplakia.

2. Lichen planus: Polygonal, flat, purple or dark red papules with a shiny surface occur at the junction of the vulvar skin and mucosal skin.

3. Lichen sclerosus and atrophicus: often occurs on the labia, with papules consistent with hair follicles visible locally. The skin lesions are atrophic blue-white flat papules that merge into pale white hypopigmented spots, often forming a "dumbbell shape" at the vaginal opening and perianal area, with mild itching, most of which are accompanied by adhesion and atrophy of the labia minora until they disappear, and atrophy of the clitoris with mild itching.

4. Vulvar vitiligo : depigmented spots with clear boundaries, no keratinization and infiltration, no itching, and similar skin lesions often occur in other parts of the body.

5. Vulvar neurodermatitis: distributed on the outer sides of the labia majora on both sides, with conscious itching, and white spots are not obvious, often accompanied by skin lesions in other parts of the body.